Gliederung

Objective: Traumatic brachial plexus lesions involve particularly young patients and have a severe impact on their lives. Despite a multitude of outcome studies reporting on postoperative improvement of various motor and sensory scores, so far little is known about patient satisfaction and disability after brachial plexus surgery. Would patients undergo surgery again, if they knew the current result in advance? How do they rate their result and their disability?

Methods: Of 319 plexus patients, operated between 1995 and 2005, 199 received a 65-item questionnaire. Measurement instruments included a new plexus-specific outcome questionnaire (ULM-Questionnaire) with categories of satisfaction, functionality, pain, co-morbidities, work and the disability of the arm, shoulder and hand questionnaire (DASH; scale 0-100).

Results: Of 99 returned questionnaires, 70 could be evaluated. C5/6 lesions (n=21/70): 90% would undergo surgery again (19/21), 95% are satisfied with the result (20/21), and 86% subjectively improved (18/21). Mean DASH score is 45. C5/6/7 (n=6/70): 50% are satisfied and would undergo surgery again (3/6), 67% improved (4/6). Mean DASH score is 56. C5 to T1 (n=43/70): 67% would undergo surgery again (29/43), 81% are satisfied (35/42), 74% experienced improvement (32/43). Mean DASH score is 76. Overall mean DASH score is 59. Pain since injury is prevalent in 86% (60/70), back pain in 53%, depression/anxiety in 21%. Fifty-two percent of those, who worked prior to injury, remain unemployed or incapacitated for work (27/53). Forty-five percent of previous “workers” returned to their former occupation (24/53). Occupational retraining was successful for 70% (16 of 23 retrained). The overall mean duration period until return to work was 9 months, 5 months for those who returned to their previous occupation.

Conclusions: 87% are satisfied with the results and 83% would undergo the procedure again. Despite a high satisfaction rate patients remain considerably disabled, half of the previous “workers” do not return to work. Occupational retraining is effective.